Dementia care — communication and screening

Regardless of whether you work in home care, residential care or hospital, you will encounter citizens with dementia. When language fails, your ability to communicate in another way becomes a core skill – not an extra task alongside care.

According to the National Knowledge Centre for Dementia, the ability to communicate is weakened when you have a dementia disease, and how it is expressed depends on which dementia disease it is and how advanced it is. The citizen may lose words, misunderstand what you say, or react with fear and anger when they cannot keep up with a conversation.

• 01Alzheimer's disease – often clear memory problems and gradually failing language.
• 02Vascular dementia – can give more fluctuating symptoms depending on where in the brain the damage is.
• 03Dementia with Lewy bodies – can cause hallucinations and severely fluctuating attention.
• 04Frontotemporal dementia – often affects behavior and personality earlier than memory.

• 01Speak briefly and concretely, and give one message at a time.
• 02Face the person, make eye contact and maintain a calm pace.
• 03Give time for responses and avoid filling the silence too quickly.
• 04Meet the person where they are in their own experience rather than correcting or debating facts.
• 05Use pictures or symbol support if words fail.

The National Knowledge Centre for Dementia points among others to Talking Mats – an image and symbol-supported method developed for people with communication difficulties. Experiences from both Denmark and abroad suggest that the method can help people with dementia express wishes and needs and participate more in decisions about their own lives.

Screening is about reducing sensory stimuli and confusion around a person with dementia: fewer people at once, less noise, familiar surroundings and a fixed structure in daily life. A calm and predictable environment can reduce confusion and the behavioural symptoms that often accompany the disease.

Restlessness, anger, wandering or suspicion – often grouped under the term BPSD – is rarely 'difficult behaviour'. It is usually an expression of a discomfort or need that the resident can no longer put into words. Your task is to search for the cause – pain, hunger, boredom or too many impressions – instead of only trying to combat the symptom.

Municipalities also work to detect dementia early. The National Knowledge Centre for Dementia describes, among other things, that Copenhagen Municipality has good experience with the BASIC-Q screening tool for older citizens suspected of dementia. As a social and health care assistant, you are often the first to notice early signs of emerging dementia in everyday life — and your observation can be what triggers an investigation.

“It is not the citizen who must remember the rules for conversation – it is you who must meet her where she is right now.”